OPINION: There’s no place like home for older and high-risk people to receive Covid-19 vaccines

There's no place like home for getting the Covid-19 vaccine - STAT Delivering the Covid-19 vaccine to people in their homes can help achieve the national distribution necessary to stop the pandemic. Patrick Skerrett STAT

Staying at home has never been so vital for older Americans and those with compromised health. After nine months of the coronavirus pandemic, sheltering in place is still the most effective protection against Covid-19 for many older adults, and likely will be until an effective vaccine helps stop the pandemic.

The virus has taken an enormous toll on our nation’s older adults. They account for 16% of the U.S. population but 80% of Covid-19 deaths, somewhat higher than their share of deaths from all causes over the same period (75%).

Covid-19 has crystallized for many the challenges that homebound older adults face when it comes to access to care. At least 2 million people ages 65 and older are permanently homebound and millions more cannot easily get to a doctor’s office. While telemedicine has exploded and living room couches have become the new exam table, virtual medicine cannot deliver vaccines — a challenge that we hope will need solving sooner rather than later.

We believe that the home should be a focal point in the effort to eradicate the virus. Bringing vaccines to the home also gives providers another opportunity to visualize the management of their patients’ chronic diseases and intervene accordingly.

The mobilization to develop a Covid-19 vaccine is the medical Manhattan Project of our time, but success is not guaranteed. ...

Without serious planning, it could take a year for a Covid-19 vaccine to reach the majority of Americans. Social determinants of health — age, race, income, geography, education, mobility, and access to health care — will complicate the challenge of providing it to everyone effectively. News that the vaccine may require two rounds of injections may make distribution even more complex and limit the rate of adoption.

These challenges must be addressed before a vaccine arrives by putting into place strategies to gain the trust of the public and reach essential adherence rates, which is needed to bring good health to all, including vulnerable and underserved populations. To that end, the home setting should be included in vaccine distribution planning. ...